To assess the life quality and social exchanges of public nursing home residents in Queensland, a study was conducted, based on a selected sample of 211 residents from four metropolitan (Brisbane) and six country nursing homes. The aim of the study was two-fold, to test the study hypothesis, and to determine changes in the respondents' lifestyle since their admission into nursing care. An interviewer-administered questionnaire was constructed, comprising closed and openended questions, concerned with the respondents' accommodation, social contact, health, recreation, life/selfperception, and demographic characteristics.
The predominant tool in life quality evaluation centred on the respondents' perception of their satisfaction/happiness with their life domains and life in general. Their social exchanges were assessed in terms of the resources reported by the respondents, and the reciprocity of their social interactions. To illustrate the common characteristics of the respondents, case studies of two typical residents were compiled. The study sample was compared against relevant Queensland populations. The hypothesis was "that a decline in social exchanges leads to a reduction in quality of life".
In brief, it was discovered that the factors showing most influence on the present quality of life were present accommodation (including, number sharing room), present health, and to a lesser extent present family contact. Based on the study outcomes, it was concluded, however, that insufficient evidence was found to support the study hypothesis. Nevertheless, it needs to be acknowledged that some interlinking appears to exist between quality of life and social exchanges.
The other study results were as follows. The majority of the respondents reported that they had been very satisfied with their past accommodation in the general community, compared to under a half who continued to feel so about their present situation in the nursing home. The main reasons for the lesser satisfaction with the current accommodation centred on such explanations as having missed their former lifestyle, including home, significant others, pets, garden, independence, and so on, and having new routines and "strangers" imposed upon them, particularly on those who did not wish to be admitted.
Furthermore, the attitude held on the day of admission appeared to have been carried over to the feeling of satisfaction with the "new" accommodation (that is, nursing home), with life in general, overall happiness, and happiness with the nursing home room. The respondents who reported having unwillingly entered nursing care were especially likely to feel resentment towards institutional living, and to those who had referred them there. The country respondents were more likely than the metropolitan ones to have exhibited a lower level of nursing home satisfaction. Family and friend contact was found to decline in frequency and therefore closeness for the respondents, after admission into institutional care.
The respondents continued to rate their health positively after admission into nursing care, possibly because they experienced similar health problems, pre- and post-admission, and continued to have a similar perception of their health in relation to that of their peers. Although present health was found to be a relatively good indicator of present life quality, its significance to social exchange appears to be minimal or non-existent. It was found that as health declined, life satisfaction/general happiness decreased as well; similarly, health was found to be directly related to the frequency of medicine taken per day. The respondents' spare time greatly increased since their admission into institutional care; the move also meant the loss of some of their past recreational activities, and the gain of new ones, such as those offered by the nursing homes, and changes to spare time/recreational companions.
The overall study data are believed to indicate that a 'resident-oriented' environment is necessary to assist more of the elderly in nursing homes to adjust with greater ease to their new lifestyle, and therefore achieve a higher life quality.